Adherence to the European Guidelines on the Management of Heart Failure in Ambulatory Care | ||||
| Benha Medical Journal | ||||
| Articles in Press, Accepted Manuscript, Available Online from 13 September 2024 PDF (260.58 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/bmfj.2024.306414.2145 | ||||
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| Authors | ||||
Basant Zahid1; Osama Sanad2; Mohamed Emad  3; Ahmed Bendary 4
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| 1Lecturer of Cardiovascular Medicine, Faculty of Medicine, Benha University, Benha, Egypt | ||||
| 2Cardiology department, Faculty of medicine, Benha University, Benha, Egypt | ||||
| 3Cardiovascular Medicine, Faculty of Medicine, Benha University, Benha, Egypt | ||||
| 4Cardiology department, Benha faculty of medicine, Benha University | ||||
| Abstract | ||||
| Background: Chronic Heart Failure (CHF) diagnosis requires symptoms/signs of HF and objective evidence of cardiac dysfunction. Effective management, as per European Society of Cardiology (ESC) guidelines, is critical for reducing mortality and improving quality of life in HF patients. This study aims to assess adherence to ESC guidelines on pharmacological and device-based treatments of HF, including angiotensin receptor neprilysin inhibitor (ARNI) and sodium-glucose Co-transporter 2 (SGLT2) inhibitors, in a contemporary cohort of Egyptian HF patients. Methods: This cross-sectional, multi-center, observational study was carried out on 500 HF patients categorized according ejection fraction into 3 groups: HFrEF, HFmrEF, and HFpEF. Data were collected via structured interviews, observations, and medical file reviews. Results: Of 500 patients, 310 had HFrEF, 115 had HFmrEF, and 75 had HFpEF. HFpEF patients had a higher mean BMI (27.6 kg/m²). HF histories (P < 0.001) varied, with HFrEF at 83.9%, HFmrEF at 67.8%, and HFpEF at 89.3%. Hospitalization histories (P < 0.001) were 39.7% in HFrEF, 13.9% in HFmrEF, and 13.3% in HFpEF. Medication use varied significantly; ACE inhibitors (P = 0.002), ARBs (P < 0.001), and ARNI (P < 0.001) were more common in HFrEF. Significant differences were observed in abnormal ECG findings (P < 0.001) and echocardiographic parameters. Device-based therapy utilization was minimal across all groups. Conclusion: Adherence to European HF guidelines is limited in Egyptian patients, with low use of ARNI and SGLT2 inhibitors. High costs, lack of awareness, and comorbidities are major barriers. | ||||
| Keywords | ||||
| Heart failure; European guidelines; ARNI; SGLT2 inhibitors; ACE inhibitors | ||||
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